Patient Assessment/Management Trauma

Transcription

1 Patient Assessment/Management Trauma Date: / / Test Site Location: Station #: Takes or verbalizes standard precautions (BSI) if appropriate based on patient scenario SCENE SIZE-UP Determines the scene is safe Determines the mechanism of injury Determines the number of patients Requests additional help if necessary Considers stabilization of spine PRIMARY ASSESSMENT Verbalizes general impression of the patient Determines responsiveness/level of consciousness (AVPU) Determines chief complaint/apparent life threats Airway Breathing Opens and Assesses airway Inserts adjunct as indicated Assessment Initiates appropriate oxygen therapy Assures adequate ventilation Injury management that compromises airway/breathing Assesses/controls major bleeding if present Circulation Assesses pulse Assesses skin (either color, temperature or condition) Initiates shock management (proper position, conserve heat) Identifies priority patients/makes transport decision/integrates treatments to preserve life HISTORY TAKING Obtains S.A.M.P.L.E. history, if able SECONDARY ASSESSMENT AND VITAL SIGNS Obtains vital signs (must include Pulse, Respirations and BP) Inspects and palpates the scalp and ears Assess the head Assesses the eyes Assesses the facial areas including oral and nasal areas Inspects and palpates the neck Assess the neck Assesses for JVD Assesses for tracheal deviation Inspects Assess the chest Palpates Auscultates Assesses the abdomen Assess the abdomen/pelvis Assesses the pelvis Verbalizes assessment of genitalia/perineum as needed Assess the extremities point for each extremity Includes inspection, palpation and assessment of motor sensory and circulatory function 4 Assesses thorax Assess the posterior Assesses lumbar Manages secondary injuries and wounds appropriately REASSESSMENT (verbalized) Verbalizes reassessment of the patient and interventions TOTAL: 42 - Did not determine scene safety 2- Did not provide for spinal protection when indicated 3- Did not assess for and verbalize high concentration of oxygen, if indicated 4- Did not find, or manage, problems associated with airway, breathing, hemorrhage or shock 5- Did other assessment before assessing the airway, breathing and circulation 6- Did not verbalize appropriate intervention or verbalized inappropriate/unsafe treatment 7- Did not verbalize transporting patient within 0-minute time limit, if EMT candidate 8- Did not obtain 33 or more points Bubble T or 2 on

2 Airway, Oxygen & Ventilation Skills Date: / / Test Site Location: ** If the candidate elects to ventilate initially with the BVM attached to oxygen, full credit must be awarded for those steps as long as the first ventilation is delivered within 30 seconds of being told to ventilate. Total Time: Note: The evaluator must advise the candidate, Please suction the patient s airway. Takes or verbalizes standard precautions (BSI) Turns on/prepares suction device Assures presence of mechanical suction (may verbalize) Inserts the suction tip without occluding thumb-hole Applies suction to the oropharynx Note: The evaluator must advise the candidate, Please insert a nasopharyngeal airway. Selects a nasopharyngeal airway Measures the nasopharyngeal airway Lubricates the nasopharyngeal airway Fully inserts the nasopharyngeal airway with the bevel facing towards the septum Note: The evaluator must advise the candidate, Please remove the nasal airway and place an oral airway. Removes the nasopharyngeal airway Selects an oropharyngeal airway Measures the oropharyngeal airway Inserts oropharyngeal airway without displacing the tongue posteriorly Note: The evaluator must advise the candidate, Please ventilate the patient with a bag-valve mask. Opens the airway using the head-tilt chin-lift Selects appropriate sized mask Creates a proper mask-to-face seal Ventilates patient at 0-2 times per minute and with adequate volume (The evaluator must witness for at least 30 seconds) Connects the BVM reservoir to oxygen regulator** Adjusts regulator liter flow to 5 liters/minute or greater** Note: The evaluator states, An EMT assistant has arrived. The candidate must instruct the EMT assistant to ventilate the patient while the candidate controls the mask and airway. Candidate reopens the airway Candidate creates a proper mask-to-face seal Candidate instructs assistant to resume ventilation at 0-2 times per minute and adequate volume TOTAL: Did not take or verbalize standard precautions (BSI) 22- Did not demonstrate an acceptable suction technique 23- Did not obtain a patent airway with the nasopharyngeal airway 24- Did not obtain a patent airway with the oropharyngeal airway 25- Inserted any adjunct in a manner dangerous to the patient 26- Did not initiate ventilations within 30 seconds of being instructed to do so 27- Interrupted ventilations for more than 30 seconds 28- Did not provide high concentration of oxygen 29- Did not provide, or direct assistant to provide, proper rate and adequate volume per breath 30- Did not receive at least 8 points Bubble M or 3 on

3 Bleeding Control/Shock Management Date: / / Test Site Location: Takes or verbalizes standard precautions (BSI) Applies direct pressure to wound with dressings Note: The evaluator must now inform the candidate, The wound continues to bleed. Applies tourniquet Note: The evaluator must inform the candidate, The bleeding is now controlled. Verbalizes dressing and bandaging the wound appropriately Note: The evaluator must inform the candidate, The patient is now showing signs and symptoms indicative of shock. Properly positions the patient with body supine Applies high concentration oxygen Initiates steps to prevent heat loss from the patient Indicates the need for immediate transportation of the patient TOTAL: 8 3- Did not take or verbalize standard precautions (BSI) 32- Did not apply high concentration of oxygen. 34- Did not control hemorrhage. 35- Did not indicate a need for immediate transportation. 36- Did not receive 6 or more points. Bubble 4 AND Wound Wound Location: 37- ARM 38- LEG

4 Immobilization Skills Joint Injury Date: / / Test Site Location: Takes or verbalizes standard precautions (BSI) if appropriate based on patient scenario Directs EMT Assistant to apply manual stabilization of the injury Assess motor, sensory and circulatory function in the injured extremity Selects proper splinting material Immobilizes the site of the injury Immobilizes the bone above the injured joint Immobilizes the bone below the injured joint Reassess motor, sensory and circulatory function in the injured extremity TOTAL: 8 4- Did not support the joint so that it did not bear distal weight 42- Did not immobilize the bone above and below the injured joint 43- Did not assess/reassess motor, sensory and circulatory function in the injured extremity before and after splinting 44- Did not obtain 6 or more points Bubble 5 AND Wound Injury Site: 45- Shoulder 46- Elbow 47- Wrist 48- Knee 49- Ankle

5 Immobilization Skills Long Bone Injury Date: / / Test Site Location: Takes or verbalizes standard precautions (BSI) if appropriate based on patient scenario Directs EMT Assistant to apply manual stabilization of the injury Assess motor, sensory and circulatory function in the injured extremity Measures the splint Applies the splint Immobilizes the joint above the injury site Immobilizes the joint below the injury site Secures the entire injured extremity Immobilizes the hand/foot in the position of function Reassess motor, sensory and circulatory function in the injured extremity TOTAL: 0 5- Grossly moves the injured extremity 52- Did not immobilize the joint above and below the injury site 53- Did not assess/reassess motor, sensory and circulatory function in the injured extremity before and after splinting 54- Did not obtain 8 or more points Injury Site: 55- Clavicle 56- Humerus 57- Radius/Ulna 58- Tibia/Fibula Bubble 6 AND Wound